Purpose: To assess corneal epithelial and stromal thickness in keratoconic and normal eyes by spectral domain optical coherence tomography (SDOCT) in an Asian population. Methods: Forty-three keratoconic and 24 normal eyes were studied and examined using SDOCT. Keratoconic eyes with corneal scarring were excluded. Epithelial and stromal thickness was assessed at 25 points, 0.5 mm apart, across the central 6 mm of the pupil centre in the horizontal and vertical meridians. The correlation between epithelial and stromal thickness in both keratoconic and normal eyes (at the corneal centre) was also assessed. Results: The corneal epithelium at the pupil centre was significantly thinner in keratoconic eyes (p < 0.05) than in controls. Epithelial thickness varied widely in keratoconic eyes compared to controls (p < 0.05). The epithelium and stroma were significantly thinner inferiorly and temporally in keratoconic eyes (p < 0.05). There was a significant correlation between epithelial and stromal thickness (at the pupil centre) in the keratoconus group (rs = 0.348, p < 0.001) but not the normal group (rs = 0.036, p = 0.376). Conclusions: Corneal epithelial thickness was markedly thinner and varied in keratoconic eyes compared to controls. Epithelial thinning occurred secondary to the abnormal elevation of the stroma. These findings are useful in detecting early keratoconus and in the evaluation of refractive surgery candidates.

1.
Li
Y
,
Tan
O
,
Brass
R
,
Weiss
JL
,
Huang
D
.
Corneal epithelial thickness mapping by Fourier-domain optical coherence tomography in normal and keratoconic eyes
.
Ophthalmology
.
2012
Dec
;
119
(
12
):
2425
33
.
[PubMed]
0161-6420
2.
Reinstein
DZ
,
Srivannaboon
S
,
Gobbe
M
,
Archer
TJ
,
Silverman
RH
,
Sutton
H
, et al.
Epithelial thickness profile changes induced by myopic LASIK as measured by Artemis very high-frequency digital ultrasound
.
J Refract Surg
.
2009
May
;
25
(
5
):
444
50
.
[PubMed]
1081-597X
3.
Ivarsen
A
,
Fledelius
W
,
Hjortdal
.
Three-year changes in epithelial and stromal thickness after PRK or LASIK for high myopia
.
Invest Ophthalmol Vis Sci
.
2009
May
;
50
(
5
):
2061
6
.
[PubMed]
0146-0404
4.
Reinstein
DZ
,
Archer
TJ
,
Gobbe
M
.
Corneal epithelial thickness profile in the diagnosis of keratoconus
.
J Refract Surg
.
2009
Jul
;
25
(
7
):
604
10
.
[PubMed]
1081-597X
5.
Zhou
W
,
Stojanovic
A
.
Comparison of corneal epithelial and stromal thickness distributions between eyes with keratoconus and healthy eyes with corneal astigmatism ≥ 2.0 D
.
PLoS One
.
2014
Jan
;
9
(
1
):
e85994
.
[PubMed]
1932-6203
6.
Rocha
KM
,
Perez-Straziota
CE
,
Stulting
RD
,
Randleman
JB
.
SD-OCT analysis of regional epithelial thickness profiles in keratoconus, postoperative corneal ectasia, and normal eyes
.
J Refract Surg
.
2013
Mar
;
29
(
3
):
173
9
.
[PubMed]
1081-597X
7.
Kanellopoulos
AJ
,
Asimellis
G
. In vivo 3-dimensional corneal epithelial thickness mapping as an indicator of dry eye: preliminary clinical assessment. Am J Ophthalmol.
2014
;157: 63–68 e62.
8.
Francoz
M
,
Karamoko
I
,
Baudouin
C
,
Labbé
A
.
Ocular surface epithelial thickness evaluation with spectral-domain optical coherence tomography
.
Invest Ophthalmol Vis Sci
.
2011
Nov
;
52
(
12
):
9116
23
.
[PubMed]
0146-0404
9.
Lohmann
CP
,
Reischl
U
,
Marshall
J
.
Regression and epithelial hyperplasia after myopic photorefractive keratectomy in a human cornea
.
J Cataract Refract Surg
.
1999
May
;
25
(
5
):
712
5
.
[PubMed]
0886-3350
10.
Reinstein
DZ
,
Gobbe
M
,
Archer
TJ
,
Silverman
RH
,
Coleman
DJ
.
Epithelial, stromal, and total corneal thickness in keratoconus: three-dimensional display with artemis very-high frequency digital ultrasound
.
J Refract Surg
.
2010
Apr
;
26
(
4
):
259
71
.
[PubMed]
1081-597X
11.
Haque
S
,
Simpson
T
,
Jones
L
.
Corneal and epithelial thickness in keratoconus: a comparison of ultrasonic pachymetry, Orbscan II, and optical coherence tomography
.
J Refract Surg
.
2006
May
;
22
(
5
):
486
93
.
[PubMed]
1081-597X
12.
Reinstein
DZ
,
Archer
TJ
,
Gobbe
M
,
Silverman
RH
,
Coleman
DJ
.
Epithelial thickness in the normal cornea: three-dimensional display with Artemis very high-frequency digital ultrasound
.
J Refract Surg
.
2008
Jun
;
24
(
6
):
571
81
.
[PubMed]
1081-597X
13.
Li
HF
,
Petroll
WM
,
Møller-Pedersen
T
,
Maurer
JK
,
Cavanagh
HD
,
Jester
JV
.
Epithelial and corneal thickness measurements by in vivo confocal microscopy through focusing (CMTF)
.
Curr Eye Res
.
1997
Mar
;
16
(
3
):
214
21
.
[PubMed]
0271-3683
14.
Schmoll
T
,
Unterhuber
A
,
Kolbitsch
C
,
Le
T
,
Stingl
A
,
Leitgeb
R
.
Precise thickness measurements of Bowman’s layer, epithelium, and tear film
.
Optom Vis Sci
.
2012
May
;
89
(
5
):
E795
802
.
[PubMed]
1040-5488
15.
Tao
A
,
Wang
J
,
Chen
Q
,
Shen
M
,
Lu
F
,
Dubovy
SR
, et al.
Topographic thickness of Bowman’s layer determined by ultra-high resolution spectral domain-optical coherence tomography
.
Invest Ophthalmol Vis Sci
.
2011
Jun
;
52
(
6
):
3901
7
.
[PubMed]
0146-0404
16.
Maeda
N
,
Nakagawa
T
,
Higashiura
R
,
Fuchihata
M
,
Koh
S
,
Nishida
K
.
Evaluation of corneal epithelial and stromal thickness in keratoconus using spectral-domain optical coherence tomography
.
Jpn J Ophthalmol
.
2014
Sep
;
58
(
5
):
389
95
.
[PubMed]
0021-5155
17.
Hashmani
N
,
Hashmani
S
,
Saad
CM
.
Wide Corneal Epithelial Mapping Using an Optical Coherence Tomography
.
[J]
.
Invest Ophthalmol Vis Sci
.
2018
Mar
;
59
(
3
):
1652
8
.
[PubMed]
0146-0404
18.
Kanellopoulos
AJ
,
Asimellis
G
.
OCT corneal epithelial topographic asymmetry as a sensitive diagnostic tool for early and advancing keratoconus
.
Clin Ophthalmol
.
2014
Nov
;
8
:
2277
87
.
[PubMed]
1177-5467
19.
Sandali
O
,
El Sanharawi
M
,
Temstet
C
,
Hamiche
T
,
Galan
A
,
Ghouali
W
, et al.
Fourier-domain optical coherence tomography imaging in keratoconus: a corneal structural classification
.
Ophthalmology
.
2013
Dec
;
120
(
12
):
2403
12
.
[PubMed]
0161-6420
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.